Childhood Disorders

• A behavioral or psychological syndrome or pattern that occurs in an individual
• Reflects an underlying psychobiological dysfunction (new to DSM-5)
• Consequences are clinically significant distress or disability
• Must not be expectable response to common stressors or losses or a cultural standard
• Not primarily result of social deviance or conflicts with society

Age is the most important

• Time course
• Quantitative indicators (high/low freq; high/low intensity)
• Qualitative indicators (inappropriate to situation; beh qualitatively different from normal)

• Language Disorders
• Austism Spectrum Disorder
• Rett's Disorder

• ADHD
• CD
• Specific Learning Disorders

• SZ
• Drug Abuse
• Bulimia Nervosa
• Anorexia Nervosa

• IDD
• Language
• Learning
• ASD
• CD
• Rumination
• Encopresis
• Enuresis
• Tourette's
• Substance Abuse
• ADHD

• Rett's
• Anxiety
• Depression (later in life, early its equal)
• Eating

Different pathways, same disorder

Similar pathways, different disorders

Disorders have many causes

• Id (Child)
• Ego (Arbiter)
• Superego (Rule-maker)

Send impulse

Receive impulse

Motor supply to muscles

Face sensation & movement

• Breathing
• Heartbeat
• Digestion

Controls motor coordination

Relay station for sensory input

Regulates behavior & emotion

• Regulates: Emotional experiences, expressions, basic drives
• Critical for learning and impulse control

• Regulates, organizes, filters info related to cognition, emotions, mood, & motor function
• Highly connected to frontal lobes

• Inhibitory NT
• Moderates emotional response, anger, hostility, aggression
• Linked to anxiety and discomfort
• Implicated in Anxiety Disorders

Involved in exploratory, extroverted and pleasure-seeking behavior

Implicated: SZ, Mood, ADHD, Substance Abuse

• Controls emergency reactions & alarm responses
• Role in regulating emotions & behavior
• Acts to modulate behavioral tendencies (OCD, etc.)

• Information processing
• Motor coordination
• Inhibits tendency to explore
• Regulates eating, sleeping, aggression

Test cause and effect

Different conditions applied to each subject

Different conditions applied to different subjects

Lifetime prevalence > Prevalence rates > Incidence rates

Number of new cases of a disorder in a specific period

All cases observed at a specific point in time

Number or proportion of cases of a disorder diagnosed at any time in life

• CT
• MRI

• EEG
• PET
• fMRI

Viewing possible normal behaviors as from a disorder due to a label

• 6 + Inattentive
• No more than 2 Hyper-Impulsive

• 6 + Inattentive
• 3-5 Hyper-Impulsive

6 of 9 Hyper-Impulsive

6 + of both

• Symptoms present before 12
• Present for 6 months
• Must occur in 2 settings
• Maladaptive
• Symptoms not from another disorder

• Genetics (highly heritable)
• Neurobiology (Frontal lobe; NTs dopamine and norepinephrine)
• Birth complications (LBW; injury at birth; small body size; prenatal smoking and alcohol)
• Psychosocial

• Property Violations
• -Setting fires
• -Stealing
• -Vandalism
• -Lying

• Aggression
• -Assault
• -Blaming
• -Fighting
• -Bullying
• -Cruelty

• Status Violations
• -Abusing substances
• -Running Away
• -Swearing
• -Breaking rules

• Oppositional Behavior
• -Annoying
• -Defiant
• -Arguing
• -Stubbornness
• -Anger
• -Touchiness

• Lasting 6 months
• 4 symptoms with at least one non-sibling
• -Angry/Irritable Mood
• -Argumentative/Defiant
• -Vindictiveness
• (No physical violence)

• 3 symptoms in past 12 months, 1 at least in past 6 months
• -Aggressive to people and animals
• -Destruction of property
• -Deceitfulness or theft
• -Serious violation of rules

• Significant Callous-Unemotional Traits
• -2 or more in past 12 months in at least 2 different settings/relationships
• -Lack of remorse or guilt
• -Callous-lack of empathy
• -Unconcerned about performance
• -Shallow or deficient affect

• Impairments in Self-functioning
• -Ego-centrism or Self-direction goal-setting
• Impairments in interpersonal functioning
• -Lack of empathy or intimacy
• Antagonism
• -Manipulativeness, decietfulness, callousness, hostility
• Disinhibition
• -Impulsivity, risk-taking
• Stable across time
• Not normative, nor substance related
• At least 18

2 or more symptoms within a 12-month period

One that is relatively normal

Especially high ability compared to norms

• Persistent deficits in social communication, interaction
• -Social-emotional reciprocity
• -Nonverbal communication
• -Developing and maintaining relationships
• Restricted, repetitive patterns/interests (2 of them)
• -Speech, motor movements, use of objects
• -Excessive routines/patterns resistant to change
• -Fixated interests
• -Hypo/Hyper-reactivity to sensory input
• Present in childhood
• Limit everyday functioning

Conceptual, Social, Practical

• Pinched X chromosome
• Large forehead, prominent jaw, low protruding ears, macroorchidism
• Hypervigilant/sensitive
• Quantitative/Visuospatial deficits

• Deletion of material from chromosome 7
• Elfin appearance
• Local over global
• Dampened amygdala activity
• Cocktail party syndrome, poetic language, musical prowess

• 7 genes on chromosome 15 missing
• Short stature, low muscle tone, urge to eat

• 7 genes on chromosome 15 missing
• Large jaw, open mouthed expression, stiff walk
• Profound desire for interaction, happy disposition
• Fascinated with water

• Deficiency in HPRT
• Self-mutilating
• Hypotonia, chorea
• Some evidence of a lessened sensitivity to pain
• Sandy diapers

• Smooth Brain, microcephaly
• Smooth filtrum, thin vermillion, short palpebral fissures

The meaning of words

The use of language in context

• Problems with phonology (making the correct sounds)
• Sound omissions are worse than sound substitutions

• Problems with morphology, semantics, or syntax
• (e.g. use of color-ers instead of crayons)
• Also related to problems with reading

• Problems with pragmatics (cannot use language in social contexts)
• Must rule out ASD
• New DSM-5 diagnosis

• Onset younger than 13
• Two or more symptoms (at least one must be delusions, hallucinations, or disorganized speech) present for 6 months

• 5+ in same 2-week period
• Depressed most of day (kids could be irritable)
• Anhedonia
• Weight loss
• Sleep issues
• Psychomotor agitation/retardation
• Fatigue
• Worthlessness
• Diminished think or concentrate
• Thoughts of death

• Single (1 MDE) or Recurrent (2+ MDE)- Presence of MDE, no manic or hypomanic
• To be considered separate must be interval of 2 consecutive months

• Depressed mood most of day for at least 1 year (adults - 2 years)
• 2+ of
• poor appetite/overeating
• Sleep problems
• Low energy or fatigue
• Low self-esteem
• Poor concentration/decision making
• Hopelessness

• Decreased frontal lobe volume
• Increase limbic system activity
• Reduced hippocampus volume
• Disturbances in HPA
• Low Serotonin, Dopamine, Norepinephrine

Mania (psychosis or clinically significant distress) for at least 1 week

Hypomania (at least 4 days) + MDE

Hypomanic symptoms, depressive symptoms (no MDE, no hypomanic episode; 1 year)

MDE + 3 non-overlapping hypomania or mania for 2 weeks

Mania + 3 non-overlapping features of depression (1 week)

Hypomania + 3 non-overlapping features of depression (4 days)

• 3 or more temper outbursts per week w/ verbal or physical aggression out of proportion
• Persistently irritable
• Present for 12 or more months (without 3 or more consecutive months of no symptoms)
• Two settings
• Not before age 6 or after 18
• Onset of symptoms before 10
• Not during MDD, not with ODD or BD --> if ODD features only DMDD diagnosed

• Rigid, "all or nothing," black and white attitude
• Overeating and purging

Highly controlled, rigid with obsessive tendencies (no b & P)

Impulsive behaviors, self-injury and substance misuse, more negative outcomes (last 3 months)

• At least once a week for 3 months
• No compensatory behavior
• Marked distress from binge eating
• Associated with low Ghrelin

Significantly underweight is a criterion for AN, NOT BN or BED

All could be except AN - Restricted

No CB in BED. Only present in BN & AN - B & P